Under Pressure, CMS Moves Forward with Limited End-to-End Testing

Under growing pressure from the healthcare industry to make certain that Medicare will be prepared for ICD-10, the Centers for Medicare & Medicaid Services (CMS) is soliciting volunteers to participate in a limited form of end-to-end testing starting in July.

The deadline for participation commitments by providers and clearinghouses is March 24. Test claims are to be submitted from July 21-25, according to CMS.

In its announcement — Change Request (CR) 8602 — CMS indicated that the testing will allow what the agency describes as a “small subset of Medicare claim submitters” to test with Medicare Administrative Contractors (MACs) and the Common Electronic Data Interchange (CEDI) contractor to “demonstrate that CMS systems are ready for ICD-10 implementation.”

Each MAC will select 32 submitters, while an additional 16 submitters will come from the Railroad Retirement Board. Volunteers are expected to be notified by the MACs and CEDI on April 14 if they have been selected to participate in the program.

“It will be important for Medicare to get a good mix of providers in the testing, both those that are ready today and are leaders in ICD-10 as well as some that are laggards,” wrote Stanley Nachimson, principal of Nachimson Advisors LLC, in an email to ICD10monitor. “And if issues are found with Medicare’s processes, I would expect them to conduct additional testing after fixing the issues.”

As plans are being made for the week of testing, the outcome of such testing is equally important to Nachimson.

“It will also be important for Medicare to provide the results of the testing in an open and timely manner,” he wrote. “Both successes and failures should be reported.”

With approximately 200 days remaining before ICD-10 becomes effective on Oct. 1, end-to-end testing is increasingly being seen as a means by which to remediate issues.

“Hopefully, the results of this testing will provide some assurance to the industry that Medicare is well-prepared for ICD-10, and we can move forward successfully on Oct. 1, 2014,” Nachimson said.